孕妇GBS感染对PROM胎膜组织细胞凋亡和胎膜弹性相关蛋白表达的影响

Influence of GBS infection on apoptosis and fetal membrane elastin-associated proteins in PROM tissues of pregnant women

目的 探讨B族链球菌(GBS)感染对胎膜早破(PROM)产妇胎膜组织中白细胞介素-18(IL-18)、基质金属蛋白酶-2(MMP-2)、B细胞淋巴瘤基因-2(Bcl-2)、Bcl-2相关X蛋白(Bax)和Rab蛋白(Rab7b)表达及妊娠结局的影响。方法 选取2017年11月-2020年11月医院收治的108例PROM产妇为PROM组,选择同期于医院分娩的无PROM产妇58名为对照组,采用免疫组化法测定两组胎膜组织中IL-18、MMP-2、Bcl-2、Bax、Rab7b蛋白表达,分析两组妊娠结局。结果 PROM组GBS感染、绒毛膜羊膜炎、剖宫产比例均高于对照组(P<0.05)。PROM组胎膜组织中IL-18、MMP-2、Bax阳性表达率和相对表达量均高于对照组,Bcl-2阳性表达率和相对表达量均低于对照组(P<0.05)。PROM组中GBS感染产妇胎膜组织中IL-18、MMP-2、Bax相对表达量均高于GBS未感染产妇,Bcl-2表达量低于GBS未感染产妇(P<0.05)。GBS感染PROM产妇新生儿早产、宫内窘迫、宫内感染发生率高于GBS未感染产妇(P<0.05)。结论 PROM产妇GBS感染率异常上升,GBS感染导致PROM产妇胎膜组织中IL-18、MMP-2、Bcl-2和Bax表达异常,并提升不良妊娠结局发生率。

OBJECTIVE To explore the effect of Group B Streptococcus(GBS) infection on expression of interleukin-18(IL-18), matrix metalloproteinase-2(MMP-2), B cell lymphoma/leukemia-2(Bcl-2), Bcl-2-associated X protein(Bax) and Rab7 b protein in fetal membrane tissues of the pregnant women with premature rupture of membrane(PROM) and pregnancy outcomes. METHODS A total of 108 pregnant women with PROM who were treated in the hospital from Nov 2017 to Nov 2020 were assigned as the PROM group, meanwhile, 58 pregnant women without PROM who gave birth in the hospital were chosen as the control group. The expression levels of IL-18, MMP-2, Bcl-2, Bax and Rab7 b in fetal membrane tissues were determined by immunohistochemistry method, and the pregnancy outcomes were observed. RESULTS The proportions of the pregnant women with GBS infection, chorioamnionitis and cesarean section were significantly higher in the PROM group than in the control group(P<0.05). The positive expression rates and relative expression levels of IL-18, MMP-2 and Bax in fetal membrane tissues were significantly higher in the PROM group than in the control group, while the positive expression rate and relative expression level of Bcl-2 of the PROM group were significantly lower than those of the control group(P<0.05). In the PROM group, the relative expression levels of IL-18, MMP-2 and Bax in fetal membrane tissues of the pregnant women with GBS infection were significantly higher than those of the pregnant women without GBS infection, while the expression level of Bcl-2 of the pregnant women with GBS infection was significantly lower than that of the pregnant women without GBS infection(P<0.05). The incidence rates of premature delivery, intrauterine distress and intrauterine infection were significantly higher among the PROM pregnant women with GBS infection than among the pregnant women without GBS infection(P<0.05). CONCLUSION The incidence of GBS infection is abnormally increased among the PROM pregnant women, the GBS infection results in the abnormal expression of IL-18, MMP-2, Bcl-2 and Bax in fetal membrane tissues of the PROM pregnant women and leads to the increase of incidence of adverse pregnancy outcomes.